Essential thrombocythemia (ET) which is a clonal disease of hematopoietic stem cell mainly reflects hyperplasia of megakaryocyte. Childhood ET is characterized by persistance of thrombocytosis, mild to moderate hepatomegalia and splenomegalia, thrombogenesis and hemorrhage complications. The pathogenesis of ET is obviously associated with the abnormal or disturbance expression of multiple genes, micro RNAs,immunological molecules and some chromosome aberration. This review will focus on recent developments in the pathogenesis of ET in molecular biology, immunology and cytogenetics.

As a member of homeobox gene family,HOXA7 is a main gene to control hematopoietie cell proliferation and differentiation.The expression and function of HOXA7 in leukemia ale regulated by many upstream elements.and affected by synergism molecules and other homeobox genes. It can induce leukemia through acting on downstream target genes.HOXA7 affects the clinical manifestation of leukemia and overexpression is closely associated with poor therapeutic reaction and prognosis.

Homeobox gene family encode a kind of transcription regulatory factors,which can specifically combine and regulate target genes,control embryonic development,cell proliferation and differentiation.Several subfamilies of homeobox gene famiy are associated with the early stage of differentiation and development of nervous system,whose abnormal expression explain the occurrence and development of nervous system diseases.Further study between homeobox gene family and nervous system can help to prevent and treat that diseases.

Pulmonary hypertension is a group of diseases with high pressure of pulmonary circula-tion,severe cases can lead to increased right ventricular afterload,even right heart failure. Children pulmonary hypertension is difficult to detect in early stage because its nonspecific clinical manifestations. It is a serious complication of many respiratory diseases,it leads to decreased lung function and life quality. Screening early pulmonary hypertension of these children will facilitate it′s diagnosis,treatment and prognosis.

A 13-year-old girl suddenly developed hypertrophic rough-surfaced plaques on both elbows, knees and ankles without obvious precipitating factors at 3 years of age.Because there was no subjective symptom or other discomfort, no treatment was given.Thereafter, the lesions neither faded nor spread.Skin examination revealed lesions covered with 1-2 mm-sized keratotic papules on the elbows and knees, which were clustered together and confluent in some areas.Circular keratotic plaques were observed on the ankles.Histopathology showed epidermal hyperkeratosis with mild parakeratosis, follicular keratotic plugs, acanthosis, broadened dermal papillae, telangiectasis and perivascular mononuclear infiltration in dermal papillae, infiltration of a few nonspecific cells in the superficial dermis.According to the clinical manifestations and histopathological findings, the patient was diagnosed with keratosis circumscripta, and treated with oral vitamin A and topical halometasone cream and urea-vitanmin E cream.The degree of skin hypertrophy and roughness was decreased after 15 days of treatment, but increased 1 month after drug withdrawal.

Objective To obtain effective siRNA fragment of HOXA10 gene and verify its function,to supply experimental evidence for tumor prevention and curation by RNAi targeting to HOXA10 gene.Methods Three pairs of small interfering RNA targeting to the different sites of HOXA10 were designed and introduced into A549.The mRNA expression of HOXA10 of A549 was detected by semi-quantitative RT-PCR,the cell proliferation was assayed by MTT,the apoptosis was measured by flow cytometry.The most effective siRNA assay was screened and was tested the relationship between it and proliferation and apoptosis.Results The mRNA of HOXA10 was inhibited by three siRNAs in A549 cells,among which siRNA1 gave the strongest inhibiting of HOXA10 by ODR was (20.190±1.698) ％.The inhibitory rate of cell proliferation was (69.793±2.092) ％ and the apoptosis rate was (29.593±2.670) ％.Conclusion siRNA1 can specifically degrade HOXA10 mRNA and inhibit the proliferation of A549 cell and promote its apoptosis.

Objective:To investigate the clinical efficacy and safety of anlotinib combined with docetaxel for the treatment of advanced non-small cell lung cancer.Methods:A total of 118 patients with advanced non-small cell lung cancer who received treatment in Jinhua Guangfu Cancer Hospital from March 2018 to June 2019 were included in this study. They were randomly assigned to receive treatment with either anlotinib combined with docetaxel (study group, n = 59) or docetaxel alone (control group, n = 59) for two treatment courses. Clinical efficacy, progression-free survival, 1-year survival rate, and adverse drug reactions were compared between the study and control groups. Results:There was no significant difference in the objective remission rate between the two groups (22.03% vs. 32.20%, χ2 = 1.544, P = 0.214). The disease control rate in the study group was significantly higher than that in the control group (88.14% vs. 69.49%, χ2 = 6.141, P = 0.013). Progression-free survival in the study group was significantly longer than that in the control group [6.92 months (95% CI: 3.83-9.54 months) vs. 3.84 months (95% CI: 2.08-6.17 months), χ2 = 5.934, P = 0.019). The 1-year survival rate in the study group was significantly higher than that in the control group [52.47% (31/59) vs. 32.20% (19/59), χ2 = 4.998, P = 0.025]. During the treatment, the proportion of patients having leucopenia, erythropenia, gastrointestinal adverse reactions and abnormal liver and kidney function in the study group was 20.34%, 13.56%, 28.81% and 5.08%, respectively, which was significantly higher than 16.95%, 10.17%, 23.73% and 3.39%, respectively in the control group ( χ2 = 0.211-0.835, P = 0.361-0.646). Conclusion:Arotinib combined with docetaxel can effectively inhibit the progression of non-small cell lung cancer, prolong the progression-free survival, increase the 1-year survival rate, and does not increase adverse drug reactions.

Objective:To describe the expression profiling of microRNAs of patients with non-small cell lung cancer. Methods:We reduced the scope of downregulated microRNAs in patients with non-small lung cancer by high throughput microarray based on quantitative real-time PCR (qRT-PCR). In this process, the downregulated microRNAs of non-small cell lung cancer tissues can be de-tected and compared with adjacent healthy lung tissues with relatively small samples. Different microRNA expression levels in non-small cell lung cancer and adjacent healthy lung tissues were verified in a large sample by RT-PCR. Results:A total of 20 types of microRNAs were significantly downregulated in non-small cell lung cancer tissues compared with adjacent healthy lung tissues. These microRNAs were listed as follows: hsa-miR-1; hsa-miR-22; hsa-miR-27a; hsa-miR-27b; hsa-miR-125a-5p; hsa-miR-125b;hsa-miR-142-5p;hsa-miR-143;hsa-miR-148a;hsa-miR-148b;hsa-miR-370;hsa-miR-373;hsa-miR-381;hsa-miR-489;hsa-miR-519a;hsa-miR-376c;hsa-miR-206;hsa-miR-380-5p;hsa-miR-223-5p;and hsa-miR-520c-3p. Among these microRNAs, 13 types were down-regulated in non-small cell lung cancer tissues as verified by RTPCR. These 13 types of microRNAs were listed as follows:hsa-miR-125a-5p; hsa-miR-143; hsa-miR-519a; hsa-miR-223-5p; hsa-miR-1; hsa-miR-520c-3p; hsa-miR-489; hsa-miR-27a;hsa-miR-373; hsa-miR-125b; hsa-miR-27b; hsa-miR-142-5p; and hsa-miR-206. Conclusion: In non-small lung cancer tissue, several kinds of microRNAs were significantly downregulated. Changes in microRNA expressions were significantly associated with tumori-genesis, progression, or other cancer cell functions in non-small cell lung cancer.

Objective To construct the uniform electron density couch model (model A ED =0.25) and two components non uniform electron density couch model (model B FD =0.5and foam core=0.1) in the Monaco treatment planning system for the iBEAM(R) evo Extension 415,and to compare which model can better quantify the treatment couch influence on radiation dose.Methods Phantom was positioned in the center of the couch,the attenuation of the couch was evaluated with 6 MV for a field size of 10 cm× 10 cm.Dose measurements of couch attenuation were performed at gantry angles from 180.0° to 122.8°,using a 0.125cc semiflex ionization chamber (PTW),isocentrically placed in the center of a homogeneous cylindrical phantom.Each experimental setup was first measured on the linear accelerator and then reproduced in the TPS.By adjusting the relative-to water electron density (ED) values of the couch,the measured attenuation was replicated.The model accuracies of the model A and model B were evaluated by comparing the measured and calculated results at the minimum computational grid (2 mm) and maximum computing grid (5 mm),respectively.Results The maximum measured and calculated percentage deviation for the central phantom position was 4.01％.The couch model was included in the TPS with a uniform ED of 0.25 or a 2 component model with a fiber ED=0.5 and foam core ED=0.1.For model A and B under 2 and 5 mm voxel grid size,the mean absorbed dose with couch was reduced to 0.61％,0.84％,0.71％ and 0.92％from 2.8％ without couch.Conclusions Model A has a good agreement between measured and calculated dose distributions for all different voxel grid sizes and gantry angles.It can accurately describes the dose perturbations due to the presence of the couch and should therefore be used during treatment planning.

Objective Comparing the dosimetric characteristics of volumetric modulated arc therapy (VMAT) and constant dose rate intensity modulated arc therapy (IMAT) in esophagus cancer to evaluate the performance of the two different arc therapy delivery techniques.Methods 22 cases of esophageal cancer patients were selected for the planning comparison study.All plans were done for IMAT and VMAT treatment plans on Oncentra 4.1 treatment planning system,prescription dose of 2 Gy in total 30 fractions.Planning objectives for PTV were at least 95％ reached the prescription dose and V110 no more than 10％.The maximum dose of spinalcord below 45 Gy and double lung dose V20 ≤ 28％,V30 ≤ 18％ were constrained.Plans were evaluated based on the ability to meet the dose volume histogram.The dose homogeneity index (HI),radiation conformity index (CI),radiation delivery time,monitor units and γ pass rate were also compared.SPSS 19.0 software paired ttest analysis was carried out on the two sets of data.Results The results showed that the IMAT plans in terms of the PTV's CI (t =3.35,P=0.003),D2(t =-2.27,P=0.034) lung's V30(t =-2.46,P=0.023) were better than that of VMAT group.But the VMAT plans spinal's V40 (t =2.37,P =0.027),lung's V5 (t =2.43,P =0.024) were superior to that of IMAT plans.There were no significant differences between IMAT and VMAT plans in the average dose of PTV,CTV,GTV,heart,spinal cord,double lung and the γpass rate.Conclusion IMAT presents a slight improvement in the OAR sparing in high dose with shorter treatment time when compared to VMAT.While in terms of delivered MU and tissue of low dose irradiated area is higher than that of in VMAT.These two treatment methods all can meet the clinical demand,which should be selected according to the actual situation of the patient.